Ferdinands Alexa, Ormandy Matt, Hodge Lesley, Mayan Maria
Faculty of Science and Technology, Athabasca University, 1 University Dr, Athabasca, AB, T9S 3A3, Canada.
Faculty of Medicine & Dentistry, University of Alberta, 2-13 HMRC 11313 87 Ave NW, Edmonton, AB, T6G 2S2, Canada.
BMC Nurs. 2025 Jul 14;24(1):914. doi: 10.1186/s12912-025-03582-z.
Healthcare aides (HCAs) are vital in supporting Canada's growing aging population. Rural communities face unique but understudied challenges to HCA recruitment and retention, including limited training options and employment opportunities. To better understand and address these challenges, this qualitative study investigated HCAs' experiences of training and working in a rural Canadian town. This training was subsidized by a municipal tuition assistance program, which provided up to $5,000 towards tuition fees.
In 2023, through a community-engaged research partnership with the town, we conducted three focus group interviews with 11 women studying to become certified HCAs, supported by the municipal tuition assistance program. Focus group interviews explored topics such as educational and work experiences, impacts of these experiences on their day-to-day lives, and their perceptions of high-quality employment. Qualitative data, including transcripts, fieldnotes, and reflexive notes, were analyzed using reflexive thematic analysis.
Participants applied to the HCA program for various reasons, arriving with diverse personal and professional backgrounds. Most participants had no previous postsecondary education. We generated three themes: (1) fostering friendships and community; (2) inspiring confidence and pride in school, the workplace, and home; and (3) working to improve the profession. Participants considered their in-person (as opposed to online) education to be a key factor in increasing their confidence at work. Engaging in union activity and advocacy work represented a significant way participants exerted their confidence and skills. Participants' engagement with their union and collective bargaining resulted in improved working conditions for local HCAs and other healthcare workers.
This study is one of few to explore rural HCA training and working in Canada and is the only one (to our knowledge) focusing on HCAs' experiences of accessing a tuition assistance program. This research also contributes to literature on improving HCA working conditions. Empowering HCAs to participate in decision-making about their work environments could lead to positive outcomes for workers and care recipients. Our findings underscore the importance of providing accessible, high-quality HCA programs in rural communities, particularly given the increasing demand for elder care in Canada.
医疗护理员对于支持加拿大不断增长的老龄人口至关重要。农村社区在招聘和留住医疗护理员方面面临独特但研究不足的挑战，包括培训选择和就业机会有限。为了更好地理解和应对这些挑战，这项定性研究调查了加拿大一个农村小镇上医疗护理员的培训和工作经历。该培训由一项市立学费援助计划提供补贴，该计划为学费提供高达5000加元的资助。
2023年，通过与该镇建立的社区参与研究伙伴关系，我们对11名正在学习以获得认证医疗护理员资格的女性进行了三次焦点小组访谈，她们得到了市立学费援助计划的支持。焦点小组访谈探讨了教育和工作经历、这些经历对她们日常生活的影响以及她们对优质就业的看法等主题。使用反思性主题分析对包括访谈记录、实地笔记和反思笔记在内的定性数据进行了分析。
参与者申请医疗护理员项目的原因各不相同，他们有着不同的个人和职业背景。大多数参与者此前没有接受过高等教育。我们得出了三个主题：（1）建立友谊和社区；（2）激发在学校、工作场所和家庭中的信心和自豪感；（3）努力改善该职业。参与者认为他们的面授教育（而非在线教育）是增强他们工作信心的关键因素。参与工会活动和宣传工作是参与者发挥其信心和技能的重要方式。参与者与工会的互动以及集体谈判改善了当地医疗护理员和其他医护人员的工作条件。
本研究是加拿大为数不多的探索农村医疗护理员培训和工作的研究之一，并且据我们所知是唯一一项关注医疗护理员获得学费援助计划经历的研究。这项研究还为有关改善医疗护理员工作条件的文献做出了贡献。赋予医疗护理员参与其工作环境决策的权力可能会为工作人员和护理接受者带来积极成果。我们的研究结果强调了在农村社区提供可及的、高质量医疗护理员项目的重要性，尤其是考虑到加拿大对老年护理的需求不断增加。
